Post on 13-Jan-2016
NEW MEXICO PUBLIC SCHOOLS INSURANCE AUTHORITY
Benefits ProgramApril 2008
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COVERED EMPLOYEES
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
Basic Life
Vol. Life
Disability
Medical
Dental
Vision
19972007
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OVERVIEW
•$276 Million Expected Claims
•Claim reserves are fully funded
•Excess Cash Balance
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BIG BID RESULTSJoint Purchasing underthe Consolidated Purchasing Act
NMPSIA, NMRHCA,State of New Mexico,APS
Quotes for Medical, Health Management, Dental, and Vision
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BIG BID RESULTSCollectively, nearly200,000 members
Bid Analysis by staff,procurement managerand each agency’sconsultants
Self-Insuredadministrative serviceOnly (ASO) fees andinsured quotes
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MEDICAL
Finalists:BCBS, Lovelace,Presbyterian,
Cigna,United HealthCare,
Award:BCBS, Presbyterian
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DENTAL
Finalists:Delta Dental NMUnited Concordia
Award:United Concordia
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VISION
Finalists:Davis Vision,Spectera, VisionService Plan
Award:Davis Vision
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PREMIUM INCREASES 10/08
Blue Cross Medical: +5.5% Presbyterian Medical: +9.9%UCCI Dental: +9.9%
Davis Vision: No ChangeThe Standard Life: No ChangeThe Standard LTD: No Change
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APPLES + ORANGES
•2% of Salary is greater than 9.9% of insurance
•3% of Salary is greater than 9.9% of insurance
•9.9% increase on employee’s portion for single dental is $.90 per month
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APPLES + ORANGES SALARY INCREASE INSURANCE INCREASE
• 3% ANNUAL INCREASE ON $13,000 = $390
• 2% ANNUAL INCREASE ON $42,000 = $900
• INSURANCE INCREASE = $72 . . . $281
• INSURANCE INCREASE =
$ 115 . . . $449
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MEDICAL REVENUE VS. MEDICAL/RX CLAIMS(in millions)
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AVERAGE MEDICAL INCREASE
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BENEFITS FUND BALANCE (in millions)
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USE OF FUND BALANCE
•Reduced 2006 increase from 11.5% to 8.75%
•Postponed 2007 7.4% from October 2007 to February 2008
•Enhanced plan benefits
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ENHANCED PLAN BENEFITS
•PCP Copay $15•Physical Therapy Copay $20•Orthodontia maximum to $1,500•Improved dental plan periodontal
benefit•$2/$5 Generic drug Copay•$0 Copay for formulary diabetic
supplies, insulin, and oral medications
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BCBS HIGH OPTION
MONTHLY IMPACT
Single Two Party Family
02/08Rates
+7.4% $434.50 $826.32 $1,103.66
10/08Rates
+5.5% $458.40 $871.78 $1,164.36
MONTHLY INCREASE
$23.90 $45.46 $60.70
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BCBS EMPLOYEE IMPACT
MONTHLYIMPACT
Single Two Party Family
INCREASE (EMPLOYER+ EE)
$23.90 $45.46 $60.70
MONTHLY INCREASE IF EE @ 40%
$9.56 $18.18 $24.28
MONTHLY INCREASE IF EE @ 25%
$5.98 $11.37 $15.18
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PRESBYTERIAN HIGH OPTION
MONTHLY IMPACT
Single Two Party Family
02/08 Rates
+7.4% $337.30 $708.26 $944.42
10/08 Rates
+9.9% $370.70 $778.38 $1,037.92
MONTHLY INCREASE
$33.40 $70.12 $93.50
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PRESBYTERIAN EMPLOYEE IMPACT
MONTHLYIMPACT
Single Two Party Family
INCREASE (EMPLOYER+ EE)
$33.40 $70.12 $93.50
MONTHLY INCREASE IF EE @ 40%
$13.36 $28.05 $37.40
MONTHLY INCREASE IF EE @ 25%
$8.35 $17.53 $23.38
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UNITED CONCORDIA (UCCI) DENTAL
MONTHLY IMPACT
Single Two Party Family
02/08Rates
0% $22.60 $43.04 $67.64
10/08 Rates
+9.9% $24.84 $47.30 $74.34
MONTHLY INCREASE
$2.24 $4.26 $6.70
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UCCI EMPLOYEE IMPACT
MONTHLYIMPACT
Single Two Party Family
INCREASE (EMPLOYER+ EE)
$2.24 $4.26 $6.70
MONTHLY INCREASE IF EE @ 40%
$.90 $1.70 $2.68
MONTHLY INCREASE IF EE @ 25%
$.56 $1.07 $1.68
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UPDATE FROM THE STANDARD
• FICA, 941, and W-2 reporting done by The Standard
• Basic Life Accelerated Benefit can equal 100% (25% specified disease + 75% terminal illness)
• Survey on Section 125 and each school’s policy on when coverage terminates
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IN CLOSING . . .
Thanks!
Questions?
Comments?
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